Organization
COASTAL CANCER CENTER LLC
Active
Other names
COASTAL CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY PAUDEL MD (PRESIDENT)
(843) 692-5000
Entity
Organization
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7902484
—
NC
05
—
PA8189
—
SC
05
—
PG1907
—
SC
05
—
PG1908
—
SC
Enumeration date
07/20/2006
Last updated
09/08/2025
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